Malnutrition and healthcare costs in older adults in Sweden: a longitudinal study based on a population-based cohort and Swedish registers

Background The study aimed to estimate healthcare costs associated with malnutrition in Swedish older adults. Methods We conducted a cohort study using data from the population-based Swedish National Study on Aging and Care in Kungsholmen (SNAC-K, N = 2982), a geriatric inpatient cohort of complex patients (N = 7680), and a cohort of individuals with cognitive impairment from the Swedish Register of Cognitive/Dementia Disorders (SveDem, N = 64192). At risk of malnutrition and malnutrition were ascertained by the Mini-Nutritional Assessment in SNAC-K and the geriatric inpatient cohort. In SveDem, body mass index was used for identifying malnutrition. Healthcare resource use was derived from regional and national registers. Associations between malnutrition and healthcare costs in 2024 Swedish kronor (SEK) were analyzed using two-part models and generalized linear regression models, adjusting for demographic and clinical factors. Findings In the community, at risk of malnutrition and malnutrition were associated with an increase in annual healthcare costs of 2267 SEK (95% CI: 64,4469) and 1846 SEK (95% CI: -6802,10493), respectively. In geriatric patients, healthcare costs over 6 months in individuals at risk of malnutrition and individuals with malnutrition were 60205 SEK (45613,74798) and 86619 SEK (68362,104875) higher than those without malnutrition. In people with cognitive impairment, malnutrition was associated with higher annual healthcare costs (22170 SEK, 95% CI: 15152,29188). Interpretation Both at risk of malnutrition and malnutrition are associated with higher healthcare costs in Swedish older adults. The study findings are important for informing future economic evaluations of malnutrition interventions in Swedish older adults.